“together”

Culture or Consequence?

One of the millions. A boy at the Village to Village Community Orphan Care Project in Domasi, Malawi

Last summer, as I made home visits with community health workers to households caring for children orphaned by AIDS, I reflected on “Africa’s communal culture.” I remember a particular day in which we visited 8 homes, caring for a total of 56 orphans. And I remember Virginia and Veronicah, two of the most amazing community health workers, saying to me half jokingly about how we could literally go door to door in the communities surrounding Eldoret and find orphans in nearly every home. We were laughing at the prospect of going door to door only because we were ankle deep in mud from rains nearly every day for a month, and we had spent the entire afternoon that day, and the one before that, and the one before that, simply making follow up visits to families needing medical care, nutritional support, or help paying for school fees and uniforms for their children. However, I knew, and they certainly knew, that we indeed could go door to door visiting new families, and it certainly was nothing to laugh about.

Spending the summer thinking about and addressing the needs of children orphaned by HIV/AIDS, I always felt a shred of hope at the end of the day when I reflected on the communal nature of the Kenyan (and I think many African) people. I was literally seeing a single disease kill an entire generation, and leave the next uneducated and jobless. However, were it not for all the grandmothers, aunts, and neighbors, millions and millions of children would be homeless. Literally, millions. What if this was America, I thought? Would orphanages be as common as Starbucks? Who would take care of all these kids? I actually had the thought that if this horrible tragedy was to happen anywhere in the world, Africa at least had a culture of sharing, of providing for and helping relatives no matter what, of sharing with your neighbors whatever is needed… and ultimately, of taking in and raising children whose parents have died.

Jump to one year later… I’m here in Malawi, standing at the bar of the Blue Elephant after watching the opening matches of Euro 2008 with my friend Hans, a medical student from Holland working here in Blantyre at Queen Elizabeth Central Hospital. He has traveled extensively across Africa (he and four friends actually rode motorbikes from Holland, around West Africa to Cameroon, and then from Uganda to South Africa, in five months!), and I think in the context of talking about our travels, we got talking about the orphan crisis and I made a comment something along the lines of, “thank god for the grandmothers, aunts, and neighbors… thank god for Africa’s communal culture… I hate to think of what would happen if there wasn’t this safety net for these orphaned children… the one saving grace I suppose.” He nodded and agreed partially, but then asked me what I meant about the “communal culture.” It was a bit loud, and at first I thought it was just the language barrier between Dutch and English, so I tried to explain what I meant and relayed to him my experiences from last summer working with these families. “I don’t know if the communal nature is necessarily culture,” he said. “I think it’s more of a consequence.”

A consequence… yes… of course. A consequence of poverty. People who are poor share and look after one another out of necessity… as a means of sustainability and survival. In the “West”, we have constructed other safety nets and support structures, such as pensions and nursing homes and life insurance. Here however, humans, and not institutions, comprise the fabric of these safety nets.

Really, I’m sure it’s a bit of both… the network of “mothers” who care for this generation of orphans is both a product of culture, and a consequence of poverty. And really… what’s the difference? How much of “culture” is really just a reflection of a country’s economic and social conditions? Maybe I’m conflating terms? Maybe I’m debating semantics? Culture or Consequence? Whichever… in the face of tragedy and hardship, the way in which I’ve witnessed people caring for one another is remarkable.